…What usually goes wrong is not that the patient gets too little oxygen but that the prescription has no target — the nasal cannula stays in…

…Symptoms The source material does not provide specific information on the clinical presentation and symptoms of the underlying conditions for which ACE inhibitors are prescribed…

…patients after acute myocardial infarction (MI), antianginal drugs have not been shown to improve long term cardiovascular outcomes in CCS. General strategy For most patients…

…may include directly observed treatment or detection of prescribed medications in blood or urine samples. In patients with an estimated glomerular filtration rate below 30…

…rest and on movement . A patient who is pain free lying still but screams when turned has not finished being titrated. Expect an opioid naive…

Procedurer Catheterisation is straightforward in most patients and dangerous in a few. The male urethra is about 25 cm long with two curves and a…

…every patient with isolated hypertension. Single Pill Combinations Fixed dose, single pill combinations are preferred whenever combination treatment is used. The number of prescribed tablets…

…drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be prescribed routinely to individuals without established ASCVD…

…for patients with chronic coronary syndrome is: Lifestyle intervention and a maximally tolerated high intensity statin. Add ezetimibe if the LDL C goal is not…

…patients at increased ASCVD risk. Ezetimibe is appropriate when the LDL C goal is not achieved with statin therapy or when statins cannot be prescribed…

…Not prescribing glucose measurement. Prescribe the measurement times at the same time as the insulin. Giving mealtime insulin to a patient who is not eating…

…a distinct disease. It identifies patients whose blood pressure remains uncontrolled despite intensive antihypertensive treatment and who therefore require assessment for pseudo resistance, secondary hypertension…

…for which sotalol is prescribed. Evaluation and Physical Examination The source material does not cover the baseline physical examination of patients prior to sotalol initiation…

…the respiratory rate, not to a schedule. Always prescribe a laxative and an antiemetic as required at the same time as the opioid. Approximate equianalgesic…

…The trials did not establish a mortality benefit. Consequently, the decision to prescribe colchicine requires attention to the balance between reduction in ischaemic events and…

…Exercise Intensity Intensity may be prescribed using several complementary approaches. Heart rate based methods For patients with cardiovascular disease, dynamic aerobic exercise may be prescrib

…Patients who have been prescribed sublingual nitroglycerin should be instructed in its appropriate use, although specific dosing instructions are not provided in the source material…

…before exercise. Patients with unstable angina pectoris with high risk should not undergo exercise stress tests; these patients should be referred to angiography instead. Exercise…

…In patients with acute decompensated heart failure, AF with rapid ventricular response is particularly important. Cardioversion is generally not immediately indicated if the patient remains…

Akutsjukvård Lathundar Basic principle Manage the patient, not the list of poisons. Stabilisation according to ABCDE, the plasma glucose, a blood gas and an ECG…

Procedurer The commonest error in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often…

…lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart rate response, arrhythmias and recovery. A patient…

…not with force. The methods that work best exploit time, gravity and slow movement; those that fail usually do so because the patient tenses up…

…when the clinical picture is unclear. Cellulitis without a pus cavity must not be incised — there, antibiotics are the treatment. Ultrasound shows the abscess as…

…a suitable vein). Standby access in a patient at risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access is not immediately available. Shock…

…selected cases the patient can be observed without anticoagulation Red flags and pitfalls A normal saturation and a normal ECG do not exclude pulmonary embolism…

…tightened the former 48 hour rule for patients with risk factors. Check what applies in your own region. The time limit is not a guarantee…

Procedurer Aspirate and biopsy answer different questions and do not replace one another: the aspirate shows cellular morphology and provides material for flow cytometry and…

…The biochemical grade alone does not indicate how acute the condition is. A patient with a chronic plasma sodium of 112 mmol/L may be…

…adrenaline or dopamine according to local practice, and does not replace pacing when the patient is markedly unstable. Transcutaneous pacing Equipment A defibrillator with a…

…the severity by the most serious finding. A patient does not have to meet every criterion in a column. Clinical deterioration or a poor response…

…Take care in impaired sensation (neuropathy, spinal cord injury) — the patient does not feel the pressure sore. Preparation and equipment Material Comment : : Stockinette Innermost against…

…outcome in sepsis and in several studies of neutropenic patients. In septic shock, or where sepsis is highly likely, antibiotics must be given immediately [3]…

…can precipitate circulatory collapse in a tamponaded patient , since positive airway pressure further reduces the venous return. Procedure Choice of access The ultrasound, not tradition…

…the patient normothermic — but fever after cardiac arrest is harmful, it often arises spontaneously, and it must be actively prevented. The treatment has therefore not…

…place, the electrodes come off, the patient has not kept a diary. The set up and the instructions decide whether the investigation will be usable…

…Most patients with this working diagnosis subsequently develop myocardial necrosis and cardiac troponin elevation, although not every patient with an initial STEMI pattern has myocardial…

…the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure…

…even though incidence and prognosis vary widely between patient groups and care settings [2]. Practical first actions Do the following in parallel, not sequentially: 1…

…in mL/min , not eGFR relative to 1.73 m². Recalculate in patients who are markedly larger or smaller than average. Higher doses may be…

…preferably two lines in a bleeding patient. A transfusion set with a filter. Blood components must not be given through a set without a filter…

…therefore the beginning of the investigation, not the end. In a frail older patient an apparently small insult — sleep deprivation, urinary retention or a new…

…intubation. A difficult airway is anticipated in a stable patient — awake fibreoptic intubation or anaesthetic back up is then the right course, not RSI. Assess…

…the patient's condition allows. 7. With titratable intravenous treatment and an unstable course, an arterial line should be considered. The blood pressure must not…

…a few days at home for a hard plug. Have the patient lie with the ear uppermost for 5 minutes after instillation. Procedure Otoscopy 1…

…must therefore not be based on the haemoglobin alone [3]. The airway Do not intubate every patient routinely before endoscopy. Observational data do not show…

…What determines whether the treatment is safe is not the starting dose but the system around the patient : that the weekly dose is adjusted in…

…patients with low or moderate pre test likelihood of obstructive CAD, CCTA or functional imaging should generally be preferred when available. Exercise ECG is not…

…STEMI occurs in approximately one third. Patients with MINOCA related STEMI generally do not have a prodrome before infarction. The clinical presentation may also reflect…

…there a further metabolic disturbance? Calculate the delta gap or delta ratio 6 Does the result fit the patient? If not, check the sample type…

…are no absolute contraindications, but refrain or adapt in: The patient does not consent — the examination must then not be carried out. Vaginismus or marked…

…be given dexamethasone. That is the practical key: the patient does not have to be left unprotected for the test to be interpretable. Procedure 1…

…is not absolute: patient phenotype, risk factors for heart failure with preserved ejection fraction, echocardiographic findings, and left atrial size must also be considered. Patients…

…findings are absent in roughly half of patients with a central cause. A normal routine neurological examination is therefore not sufficient to exclude stroke [3…

…of objectively demonstrating peripheral arterial disease, and it is needed more often than it is used — not only in claudication, but before every compression treatment…

…is not burned. 5. Inspect again after 10–15 minutes. If the bleeding persists after two attempts — move on to packing. 6. Apply antibiotic ointment…

…since ingestion, and both can harm the patient through aspiration. Contact your national or regional poison control centre before you decide, not afterwards. Indications Medicinal…

…chronic value [4]. The grading must not be used mechanically. A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute…

…muscle in a slim patient. 4. Insert the needle perpendicularly , quickly and firmly, to its full length. 5. Aspiration is not needed for vaccination in…

…cardiac arrest when the person ventilating is not experienced in intubation. Planned anaesthesia for short procedures in a fasted patient at low risk of aspiration…